Fracture of a Titanium Non-Modular Femoral Stem After Revision Total Hip Arthroplasty A Case Report and Review of the Literature.

Background: Femoral stem fracture is a rare and morbid complication after total hip arthroplasty (THA). There currently exists a paucity of reports regarding cementless non-modular, titanium, femoral stem fractures.

Methods: A case report and review of the literature for modular and non-modular stem fractures was conducted.

Anticoagulation in Revision Total Joint Arthroplasty: A Retrospective Review of 1917 Cases.

Although several studies now support the use of aspirin for venous thromboembolism (VTE) prophylaxis in primary total hip arthroplasty (THA) and total knee arthroplasty (TKA), the optimal chemoprophylactic agent in revision THA and TKA is not clear. The purpose of this study was to determine if the type of chemoprophylaxis has an effect on the VTE rate in patients undergoing revision total joint arthroplasty (TJA). The second aim was to compare differences in rates of wound drainage in primary and revision TJA stratified by the postoperative chemoprophylaxis used.

Physical Therapy on Postoperative Day Zero Following Total Knee Arthroplasty: A Randomized, Controlled Trial of 394 Patients.

Background: Surgeons have increasingly emphasized early mobilization as a way to facilitate discharge following total knee arthroplasty (TKA). The purpose of this study was to determine whether starting formal physical therapy (PT) the afternoon of postoperative day (POD) 0, instead of starting PT the morning of POD 1, could shorten hospital length of stay (LOS).

Methods: Patients undergoing elective TKA with a planned minimum 1-night hospital stay were randomized to start formal PT the afternoon following surgery or the morning of POD 1.

A Novel, Automated Text-Messaging System Is Effective in Patients Undergoing Total Joint Arthroplasty.

Background: Digital patient engagement platforms are designed to improve the efficacy of the perioperative surgical home, but the currently available solutions have shown low patient and provider adoption. The purpose of this study was to evaluate the effectiveness of a text-messaging (Short Message Service [SMS]) bot with respect to patient engagement following joint replacement procedures in a randomized clinical trial.

Methods: One hundred and fifty-nine patients (83 patients in the control group and 76 patients in the intervention group) were enrolled in a randomized controlled trial comparing the effectiveness of an SMS bot (intervention group) with the traditional perioperative education process (control group) in patients undergoing primary total knee or hip arthroplasty.

Patient Preferences in Office-Based Orthopedic Care: A Prospective Evaluation.

Patient satisfaction has become a topic of interest within orthopedics as the landscape of provider reimbursement continues to evolve to reward value of care. Online internet physician rating sites are becoming increasingly popular ways for patients to subjectively express their provider experience. Understanding what patients value during their episode of care is important in the modern healthcare environment.

A Survey of the Prevalence of and Techniques to Prevent Trunnionosis.

Trunnionosis of total hip arthroplasty (THA) components has been an increasingly reported complication. Consensus is lacking regarding preventive practices and the overall incidence of trunnionosis. In this study, fellowship-trained adult reconstruction orthopedic surgeons were surveyed to identify expert opinions.

Is There Any Role for Direct Repair of Extensor Mechanism Disruption Following Total Knee Arthroplasty?

Background: Extensor mechanism disruption remains a challenging problem in total knee arthroplasty (TKA) with historically poor outcomes. The purpose of our study is to determine if patients undergoing acute extensor mechanism repair had different outcomes than patients undergoing allograft reconstruction.

Methods: We reviewed a series of 126 total knee arthroplasty patients requiring surgical repair or reconstruction of an extensor mechanism injury from 2005 to 2014 with a minimum of 24 months of follow-up.

Clinical Outcomes and Survivorship of Lateral Unicompartmental Knee Arthroplasty: Does Surgical Approach Matter?

Background: Lateral unicompartmental knee arthroplasty (UKA) has been shown to be an effective procedure to treat isolated lateral compartment osteoarthritis with excellent long-term survivorship. Whether a medial parapatellar approach or a lateral parapatellar approach is superior in lateral UKA is unknown. The purpose of this study was to determine if there is a difference in intermediate-term clinical outcomes in patients undergoing lateral UKA through a lateral vs medial parapatellar approach.

Can Bundled Payments Be Successful in the Medicaid Population for Primary Joint Arthroplasty?

Background: Although some bundled payment models have had success in total joint arthroplasty, concerns exist about access to care for higher cost patients who use more resources. The purpose of this study is to determine whether Medicaid patients have increased hospital costs and more resource utilization in a 90-day episode of care than Medicare or privately insured patients.

Methods: We retrospectively reviewed a consecutive series of 7268 primary hip and knee arthroplasty patients at a single institution.

Prospective Assessment of Sleep Quality Before and After Primary Total Joint Replacement.

Sleep disruption is a common, yet rarely addressed, complaint among patients who have undergone total joint arthroplasty (TJA). This study assessed sleep quality before and after primary TJA. A total of 105 patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) prospectively completed questionnaires during the preoperative, early postoperative, and late postoperative periods.